Amanda Corbin, RN

Individual provider Active NPI School Registered Nurse · Aztec, NM

NPI 1265198535 · NPPES record last updated Nov 11, 2021

Key facts

NPI
1265198535
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
RN-73464 (NM)
Practice address
507 S Park Ave
Aztec, NM 87410-2253
Phone
(505) 334-9469
NPI assigned
Nov 11, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-73464NMMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN-73464 NM Yes

Addresses

Primary practice location

507 S Park Ave
Aztec, NM 87410-2253

Mailing address

11 Road 2626
Aztec, NM 87410-2801
Phone (505) 947-1098

Other providers in Aztec, NM

All providers in Aztec, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.